dacarbazine

Contraindicated in:

Hypersensitivity;
OB:
Pregnancy
;
Lactation: Lactation.

Use Cautiously in:

Active infection;
Bone marrow depression;
Renal impairment;
Hepatic impairment;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: alopecia, facial flushing, photosensitivity, rash

Endo: gonadal suppression

GI: anorexia, nausea, vomiting, diarrhea, HEPATIC NECROSIS, hepatic vein thrombosis

Hemat: anemia, leukopenia, thrombocytopenia

Local: pain at IV site, phlebitis at IV site, tissue necrosis

MS: myalgia

Neuro: facial paresthesia, malaise

Misc: ANAPHYLAXIS, fever, flu-like syndrome

Interactions ⬆ ⬇

Drug-drug:

Additive bone marrow depression with other antineoplastics.
Carbamazepine, phenobarbital, and rifampin may ↓ levels and effectiveness.
Amiodarone, ciprofloxacin, fluvoxamine, ketoconazole, ofloxacin, isoniazid, or miconazole may ↑ levels and risk of toxicity.
May ↓ antibody response to live-virus vaccines and ↑ risk of adverse reactions.

Availability ⬆ ⬇

(Generic available)

Powder for injection: 100 mg/vial; 200 mg/vial

Route/Dosage ⬆ ⬇

Malignant Melanoma

IV (Adults ): 2–4.5 mg/kg/day for 10 days administered every 4 wk or 250 mg/m²/day for 5 days administered every 3 wk.

Hodgkin Disease

IV (Adults ): 150 mg/m²/day for 5 days (in combination with other agents) administered every 4 wk or 375 mg/m² (in combination with other agents) administered every 15 days.

Action ⬆ ⬇

Disrupts DNA and RNA synthesis (cell-cycle phase-nonspecific).

Therapeutic effects:

Death of rapidly growing tissue cells, especially malignant ones.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: alkylating agents

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues; probably concentrates in liver; some CNS penetration.

Metabolism/Excretion: 50% metabolized by the liver; 50% excreted unchanged by the kidneys.

Half-Life: 5 hr (↑ in renal and hepatic impairment).

Time/Action Profile ⬆ ⬇

(effects on blood counts)

ROUTE	ONSET	PEAK	DURATION
IV (WBCs)	16–20 days	21–25 days	3–5 days
IV (platelets)	unknown	16 days	3–5 days

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy.
Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care provider before taking other medications.
Instruct patient to notify health care provider if fever; chills; sore throat; signs of infection; bleeding gums; bruising; petechiae; abdominal pain; yellowing of eyes; or blood in urine, stool, or emesis occur. Caution patient to avoid crowds and persons with known infections. Instruct patient to use soft toothbrush and electric razor. Patients should be cautioned not to drink alcoholic beverages or take products containing aspirin or NSAIDs; may increase GI irritation.
May cause photosensitivity. Instruct patient to avoid sunlight or wear protective clothing and use sunscreen for 2 days after therapy.
Instruct patient to inform health care provider if flu-like syndrome occurs. Symptoms include fever, myalgia, and general malaise. May occur after several courses of therapy. Usually occurs 1 wk after administration. May persist for 1–3 wk. Acetaminophen may be used for relief of symptoms.
Discuss with patient the possibility of hair loss. Explore coping strategies.
Instruct patient not to receive any vaccinations without advice of health care provider.
Rep:
May cause fetal harm. Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected and to avoid breastfeeding during therapy. Advise patient of the need for a nonhormonal method of contraception.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

0143- Hikma Pharmaceuticals USA Inc.
- 0143-9245- Dacarbazine
  - 0143-9245-10- 10 VIAL in 1 CARTON (0143-9245-10) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL (0143-9245-01)

42973- Apicore Pharmaceuticals Private Limited
- 42973-149-
  - 42973-149-00- 50 kg in 1 DRUM (42973-149-00)

54875- Heraeus Precious Metals GmbH & Co. KG
- 54875-0003-
  - 54875-0003-1- 1 BOTTLE, PLASTIC in 1 BAG (54875-0003-1) / 2000 g in 1 BOTTLE, PLASTIC

63323- Fresenius Kabi USA, LLC
- 63323-127- Dacarbazine
  - 63323-127-10- 10 VIAL, SINGLE-DOSE in 1 TRAY (63323-127-10) / 10 mL in 1 VIAL, SINGLE-DOSE (63323-127-00)

63323- Fresenius Kabi USA, LLC
- 63323-128- Dacarbazine
  - 63323-128-20- 10 VIAL, SINGLE-DOSE in 1 TRAY (63323-128-20) / 20 mL in 1 VIAL, SINGLE-DOSE (63323-128-00)

71288- Meitheal Pharmaceuticals Inc.
- 71288-174- Dacarbazine
  - 71288-174-21- 10 VIAL, SINGLE-USE in 1 CARTON (71288-174-21) / 20 mL in 1 VIAL, SINGLE-USE (71288-174-20)

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇